Evidence map›Paper›PMID 38922754›Full record

ArticleJournal of applied clinical medical physics2024

Optimal minimum MU for intensity-modulated proton therapy with pencil-beam scanning proton beams.

ByongYong Yi, Sina Mossahebi, Jenna Jatczak, Michelle Mundis, Thomas Houser, David Alicia, Dong Han, Rosette Gonzalez, Stephen Olis, Mark Zakhary

Abstract read
In one paragraph

Article in Journal of applied clinical medical physics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

ByongYong YiDepartment of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0002-8805-0250
Sina MossahebiDepartment of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0001-9007-3112
Jenna JatczakMaryland Proton Treatment Center, Baltimore, Maryland, USA.
Michelle MundisMaryland Proton Treatment Center, Baltimore, Maryland, USA.
Thomas HouserMaryland Proton Treatment Center, Baltimore, Maryland, USA.
David AliciaMaryland Proton Treatment Center, Baltimore, Maryland, USA.
Dong HanNew York Proton Center, New York, New York, USA.ORCID https://orcid.org/0000-0003-4010-1220
Rosette GonzalezMaryland Proton Treatment Center, Baltimore, Maryland, USA.ORCID https://orcid.org/0009-0002-7516-6614
Stephen OlisMaryland Proton Treatment Center, Baltimore, Maryland, USA.ORCID https://orcid.org/0009-0002-4705-4316
Mark ZakharyDepartment of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0003-4333-648X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA higher minimum monitor unit (minMU) for pencil-beam scanning proton beams in intensity-modulated proton therapy is preferred for more efficient delivery. However, plan quality may be compromised when the minMU is too large. This study aimed to identify the optimal minMU (OminMU) to improve plan delivery efficiency while maintaining high plan quality.

methodsWe utilized clinical plans including six anatomic sites (brain, head and neck, breast, lung, abdomen, and prostate) from 23 patients previously treated with the Varian ProBeam system. The minMU of each plan was increased from the current clinical minMU of 1.1 to 3-24 MU depending on the daily prescribed dose (DPD). The dosimetric parameters of the plans were evaluated for consistency against a 1.1-minMU plan for target coverage as well as organs-at-risk dose sparing. DPD/minMU was defined as the ratio of DPD to minMU (cGy/MU) to find the OminMU by ensuring that dosimetric parameters did not differ by >1% compared to those of the 1.1-minMU plan.

resultsAll plans up to 5 minMU showed no significant dose differences compared to the 1.1-minMU plan. Plan qualities remained acceptable when DPD/minMU ≥35 cGy/MU. This suggests that the 35 cGy/MU criterion can be used as the OminMU, which implies that 5 MU is the OminMU for a conventional fraction dose of 180 cGy. Treatment times were decreased by an average of 32% (max 56%, min 7%) and by an average of 1.6 min when the minMU was increased from 1.1 to OminMU.

conclusionA clinical guideline for OminMU has been established. The minMU can be increased by 1 MU for every 35 cGy of DPD without compromising plan quality for most cases analyzed in this study. Significant treatment time reduction of up to 56% was observed when the suggested OminMU is used.

Indexed as

NeoplasmsOrgans at RiskProton TherapyRadiotherapy DosageRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-AssistedBreast NeoplasmsFemaleHead and Neck NeoplasmsHumansMaleRadiometryintensity‐modulated proton therapyminimum monitor unitproton pencil‐beam scanningtreatment time

Identifiers

PMID38922754
PMCPMC11492354

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.